[Ischemic stroke: the cardiac workup]

Area of Science:

• Cardiology
• Neurology
• Clinical Medicine

Background:

• Cardiac evaluations like Holter monitoring and echocardiography are frequently used after stroke to find embolic sources.
• Identifying cardiac sources such as atrial fibrillation (AF) or intracardiac thrombus can alter secondary prevention strategies.

Purpose of the Study:

• To systematically review current guidelines on cardiac workup after stroke.
• To evaluate the diagnostic yield and utility of routine cardiac investigations for stroke.
• To determine if targeted or systematic testing is more appropriate for stroke patients.

Main Methods:

• Systematic review of existing clinical guidelines.
• Analysis of recommendations for cardiac investigations post-stroke.

Main Results:

• The diagnostic yield of routine Holter monitoring and echocardiography in stroke patients is limited.
• There is a lack of consensus regarding the utility of these examinations for all stroke types.
• Current guidelines suggest a more targeted approach to cardiac workup rather than systematic screening.

Conclusions:

• Cardiac investigations post-stroke should be selectively applied based on patient risk factors and clinical presentation.
• A targeted strategy may improve the efficiency and effectiveness of secondary stroke prevention.
• Further research is needed to clarify the optimal use of cardiac workup in specific stroke etiologies.